Orthostatic hypotension is a common, treatable cause of falls, and it is often missed because the reading is taken too quickly. Measure after the patient has lain flat for at least five minutes, then at one and three minutes after standing.
A fall of 20 mmHg systolic or 10 mmHg diastolic is significant, but symptoms on standing matter even without that threshold. Review antihypertensives, diuretics, alpha-blockers and antidepressants when it is found.
- Measure lying blood pressure after at least five minutes supine
- Repeat at one and three minutes after standing
- Record symptoms on standing, not just the numbers
- Review blood pressure-lowering and sedating drugs when postural drop is found
Why it matters
A rushed reading misses one of the most correctable causes of falls.
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